LDL/HDL Ratio · high result
What does a high LDL/HDL Ratio mean?
Short answer
An LDL/HDL ratio above 3.5 means 'bad' cholesterol outweighs 'good' by a margin associated with higher cardiovascular risk. It rises with high LDL (diet, genetics, hypothyroidism) or low HDL (insulin resistance, smoking, inactivity). The ratio is a shorthand; ApoB and non-HDL cholesterol are the numbers guidelines act on.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
What is the normal range for LDL/HDL Ratio?
- age 18+: 0.000 – 3.50 ratio
Above 3.5 suggests elevated cardiovascular risk; below 2.0 is considered ideal.
Full reference table, citations and testing options: LDL/HDL Ratio biomarker page.
What are the common causes of high LDL/HDL Ratio?
- High LDL: saturated-fat-heavy diet, familial hypercholesterolemia, hypothyroidism, nephrotic syndrome
- Low HDL: insulin resistance, smoking, inactivity, high triglycerides
- Anabolic steroids, some medications
What symptoms go with high LDL/HDL Ratio?
- None
What do clinicians usually check next?
- ApoB and Lp(a) once; A1c, TSH
- Blood pressure and smoking status for a 10-year risk estimate
- Repeat lipids 6–12 weeks after diet or medication changes
Follow-up tests available at TestWell: TSH (Thyroid Stimulating Hormone) ($26.99), TSH + Free T4 ($27.99).
How do you recheck LDL/HDL Ratio?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Lipid Panel with LDL/HDL Ratio | Test · 5 biomarkers | $24.99 | Yes | 1–3 business days |
Common questions
What is a good LDL/HDL ratio?
Under 3.5 is the conventional cutoff; under 2.5 is often quoted as optimal. Guidelines now prefer ApoB or non-HDL targets over ratios because a ratio can look fine while both numbers are wrong.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.